Department of Otolaryngology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, China.
Acta Otolaryngol. 2022 May;142(5):375-380. doi: 10.1080/00016489.2022.2071987. Epub 2022 May 12.
The effects of graft thickness on tympanoplasty is uncertain.
To compare the results of endoscopic tympanoplasty using different thicknesses of autologous tissues.
This retrospective analysis included 186 patients who received type I tympanoplasty, divided into three main groups based of grafting material: perichondrium (A), cartilage-perichondrium (B), or cartilage-perichondrium plus additional perichondrium (C). Group A was subdivided based on whether the placement was inside (A1) or outside (A2) of the malleus. The hearing improvement, graft success rate, and surgery duration were analysed.
Statistical analysis showed significant hearing improvement in the three main groups ( < .001); recovery in group A occurred the earliest. Six months postoperatively, group A1 showed significantly greater hearing recovery compared with groups B and C ( < .05). There were no statistical differences the other groups ( > .05) or in the graft success rate among the three main groups ( = .235). The surgery duration of group A was significantly longer than that of groups B and C ( < .001).
Our results suggest that graft thickness affects hearing recovery; however, graft thickness does not affect the rate of grafting success. Endoscopic transplantation of the perichondrium is more difficult and requires more time.
移植物厚度对鼓室成形术的影响尚不确定。
比较使用不同厚度自体组织进行内镜鼓室成形术的结果。
本回顾性分析纳入了 186 名接受 I 型鼓室成形术的患者,根据移植物材料分为三组:软骨膜(A)、软骨-软骨膜(B)或软骨-软骨膜加额外软骨膜(C)。根据放置位置是在锤骨内(A1)还是外(A2),A 组进一步分为两组。分析听力改善、移植物成功率和手术时间。
统计分析显示三组听力均有显著改善( < .001);A 组恢复最早。术后 6 个月,A1 组听力恢复明显优于 B 组和 C 组( < .05)。其他两组间无统计学差异( > .05)或三组间移植物成功率无差异( = .235)。A 组的手术时间明显长于 B 组和 C 组( < .001)。
我们的结果表明,移植物厚度会影响听力恢复;然而,移植物厚度不会影响移植物成功率。内镜下移植软骨膜更困难,需要更多时间。